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Введение. Показано, что прогноз после острого инфаркта (ИМ) имеет сильную корреляционную взаимосвязь с интенсивностью воспалительной реакции в ответ на повреждение миокарда. В связи с этим для мониторинга постинфарктного воспаления требуются новые диагностические подходы. Сцинтиграфия с меченными технецием-99m аналогами сомастостатина является перспективным методом визуализации постинфарктного воспаления, однако ее клиническое значение мало изучено. Материал и методы. В исследование включено 6 пациентов с передним ИМ с подъемом сегмента ST. Всем пациентам была проведена ОФЭКТ-КТ грудной клетки 99mТс-тектротидом и перфузионная сцинтиграфия миокарда в состоянии покоя в подостром и отдаленном (8 мес) периоде. Результаты. В подостром периоде дефекты перфузии миокарда были выявлены у всех пациентов (SRS 11.83 ± 8.89). В то же время накопление 99mТс-тектротида в миокарде было выявлено у 3 пациентов из 6 обследованных. В отдаленном периоде интенсивное накопление 99mТс-тектротида отмечалось только у 1 пациента из 6 и носило более распространенный характер по сравнению с подострым периодом ИМ. Заключение. Сцинтиграфия миокарда с 99mTc-тектротидом позволяет выявить сверхэкспрессию рецепторов соматостатина у пациентов, перенесших ИМ как в подостром, так и в отдаленном периоде.
Ключевые слова:
99mТс-тектротид, сцинтиграфия, острый инфаркт миокарда Авторы подтверждают отсутствие конфликтов интересов, 99mТс-Tektrotyd, scintigraphy, acute myocardial infarction
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Background. It has been shown that prognosis following acute myocardial infarction (MI) strongly correlates with intensity of inflammatory reactions in response to myocardial injury. Thereby diagnostic methods for myocardial post-infarction inflammation (PII) monitoring are needed. Scintigraphy with somatostatin receptor targeted radiotracers has prospects for PII imaging, but its clinical value is poorly studied. Methods. Six patients with ST-segment elevation anterior myocardial infarction (STEMI) were examined by chest SPECT/СT with 99mТс-Tektrotyd and rest myocardial perfusion scintigraphy (MPS) at subacute and remote (8th month) period of the disease. Parameters of both scintigraphic methods were estimated. Results. In subacute stage of MI myocardial perfusion defects were revealed in all 6 patients (mean SRS 11.83 ± 8.89), 99mTc-Tektrotyd uptake in myocardium was revealed in 3 of 6 patients. At remote period intense uptake of 99mTc-Tektrotyd was found only in 1 patient. This uptake was more spread and clears, comparing with accumulation in subacute stage of AMI. Conclusion. Myocardium scintigraphy with 99mTc-Tektrotyd allows identifying overexpression of somatostatin receptors in areas of recent and old myocardium infarction. In some patients the radiopharmaceutical uptake may expands to a remote period of the disease. Further larger studies and histological validation of scintigraphic results are needed.
Keywords:
99mТс-тектротид, сцинтиграфия, острый инфаркт миокарда Авторы подтверждают отсутствие конфликтов интересов, 99mТс-Tektrotyd, scintigraphy, acute myocardial infarction
